This National Development Team for Inclusion (NDTi) report highlights the challenges in supporting and encouraging change to private sector learning disability hospitals.

The project ran for 18 months and set out to encourage private sector providers to change their services to reflect national policy as set out in the Mansell report. This included reducing the number private hospital beds, enabling people to leave hospitals for community services and supporting providers to develop alternative service models.

Whilst limited progress towards the goals was achieved, the project did identify a number of challenges to achieving them:

A lack of desire to change services whilst a market for them still exists

Financial returns were a greater driver than delivery of national policy

The current challenging economic climate adds makes change difficult while still delivering financial returns for the organisation .

Local commissioners must be the drivers of change, but there are insufficient levers in the system to make this a priority in NHS and local authority commissioners.

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.